DIET PADA PASIEN

PASCA BEDAH
CAESAREA SECTION

Diniyah Kholidah
 Reason for Procedure

 Large baby
 Pregnancy with twins or more
 Baby is not in a head-down position
 Maternal medical conditions, for example, diabetes, high
blood pressure, active herpes infection, or HIV-positive
 Problem with the position of the placenta
 Failure of labor to progress
 Baby shows signs of distress, such as an abnormal heart
rate during labor
 Previous cesarean birth
 Fetal problems
Possible Complication

 Infection
 Bleeding
 Decreased bowel function
 Damage to other organs in the abdomen
 Longer hospital stay and recovery time
 Bad reactions to anesthesia
 Risk of additional surgeries, including
hysterectomy, bladder repair, or repeat C-sections
with future pregnancies.
General Abdominal Surgery
 Pasien tidak diberikan makanan/minuman
selama periode waktu tertentu hingga tanda2
kembalinya fungsi usus :
 BU + (N)
 Abd : Flat, supel

 Bowel surgery,
 BU berubah
 Fungsi usus tidak terganggu
Hasil penelitian :
fungsi GIT segera kembali pasca operasi
General Abdominal Surgery

 Clinical manifestation (Kramer, 1996) :

 Delayed bowel motility

 The onset of bowel function influence by the

type of surgery performed
 Ileus paralitik
Status Gizi Perioperatif

 Status gizi untuk penyembuhan (lebih diutamakan)

 Memperbaiki status gizi difokuskan pd diet

 Post injury : perub. metab. makro-mikro nutrient

Healing requires energy, with glucose being the

major fuel source for the synthesis of collagen
By consuming enough calories, it will “spare” the
use of protein for energy
The recommendation for calories is 25-30 kcal/kg
to 30-35 kcal/kg, protein is 1.2 to 1.5 g/kg
Latar Belakang

Prinsip gangguan gizi pada pasien pasca bedah

secara umum adalah :

 Starvasi – ok. penyakit dan asupan kurang

 Efek stres metabolik - ok. inflamasi,
katabolisme, penurunan anabolisme
Post op SCTP standing order

 Post SCTP, pengelolaan pasien bervariasi :

 24 hour after surgery
Validitas ???
 Early oral fluid/food
Post op SCTP standing order
24 after surgery

 24 hour after surgery

 SC is a major surgery, complication risk from
giving oral fluid/food after surgery
 (Seller, 1993), 12-24 jam puasa post op., saliva
dan cairan lambung, full liquid diet hari ke-2,
regular diet (BU +, flatus) hari ke-3
 Post op SCTP standing order
Early oral fluid/food after surgery
 Early oral fluid/food
 Bowels are not usually exposed
during SC
----- normal bowel function.

 (Sweet, 1997), cairan diberikan sesaat

pasca op. dan a light diet ketika pasien
siap untuk makan.
 (Knupple, 1993), puasa intra op, cairan
hangat as early as (1 jam post op SC dg
anestesi lokal, regular diet jika pasien
lapar)
Post op SCTP standing order
Early Oral Fluid/Food
 (Bennet, 1999), pemberian makanan pasien post
SC tidak harus menunggu bising usus (+) N,
meskipun pada wanita dengan ileus paralitik.
 Rekomendasi : cairan diberikan bersamaan
dengan pemberian makanan (light diet).

NOTE :
It is only when the surgeon, for one reason or the other
(ex. extensive intra abdominal manipulations or sepsis),
requests that food be withheld until bowel sounds are
heard, that the woman may be refused food.
Early Oral Fluid/Food (Mangesi L, Hofmeyr GJ, 2007)

 Segera memberikan makanan padat pada pasien

a light diet, regular diet (dengan memperhatikan
gejala klinis)
 Mengurangi waktu bising usus
 Mengurangi lama hari rawat inap
 Mengurangi gejala distensi abdomen(distended)
Early Oral Fluid/Food (Mangesi L, Hofmeyr GJ, 2007)

 Segera memberikan makanan padat pada pasien

a light diet, regular diet (dengan memperhatikan
gejala klinis)
 Mengurangi waktu bising usus
 Mengurangi lama hari rawat inap
 Mengurangi gejala distensi abdomen(distended)
Early Oral Fluid/Food (Mangesi L, Hofmeyr GJ, 2007)

 Pemberian makanan sesegera mungkin post SC,

tidak ada perbedaan signifikan terhadap
terjadinya komplikasi pasca op (mual, muntah,
waktu aktif GIT, flatus, ileus paralitik, jumlah dosis
analgesik).
 Kebutuhan Energi dan Protein
Pasca Bedah

Tanpa Stres
komplikasi metabolik
Energi (Kcal/kg/hari) 25 - 30 30 - 35
Protein (g/kg/hari) 1.2 – 1.3 1.4 – 1.5
Perkembangan Diet Post Op. C- Section

 menggambarkan perkembangan standar asuhan

gizi pada pasien post-op SCTP secara tepat dan
aman.

Conventional Feeding for Patients Undergoing

Cesarean Section
VS
Early Postoperative Feeding for patients
Undergoing Cesarean Section
Chantarasorn, V and Tannirandorn, Y
J Med Assoc Thai 2006; 89 (Suppl 4): S11-6
Perkembangan Diet Post Op. C- Section

 Hasil penelitian :
 mengurangi tingkat gejala ileus

 menawarkan manfaat potensial (waktu BU

dan peristaltik usus, hari rawat inap lbh
pendek)

Namun, asuhan gizi post op. SC

membutuhkan konseling yang tepat dan
fleksibilitas untuk pasien.
PUMPKIN CREAM SOUP

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 LONDONDERRY
SOUP

20
 CARAMEL
PUDDING
21
 Soufflé
22
 CHAWAN MUSHI

23
 SUP CUSTARD
ISI AYAM JAMUR

24
 CROQUE MONSIEUR

25
 GARDEN EGGS SALAD
SANDWICH
26
 SMOKED BEEF SANDWICH

27
 French Bread

28
 EGGS & CHEESE
BURGER
WITH POTATO

29
 CHICKEN CORDON BLEU
30
 MENU NASI TIM KOMPLIT
1 porsi = 539 Kalori

31
 Cassava Thai Dessert

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